Catherine Marco, MD: "The physician-patient relationship is based on trust and confidentiality. The importance of patient privacy and confidentiality is recognized in today's world by HIPAA, the American Medical Association Code of Ethics, and the ACEP Code of Ethics. Filming of ED patient encounters may breach patient privacy, may impede honest and open communications, and may lead to reluctance for certain patients to seek emergency care. ACEP has stated in its policy Filming in the Emergency Department: The American College of Emergency Physicians (ACEP) opposes the filming for public viewing of emergency department patients or staff members except when they can give fully informed consent prior to their participation. The medical record should accurately reflect patient encounters without the need for body cameras, with their inherent risks of violations of patient privacy and confidentiality."

Matthew Pirotte, MD: "Body cameras raise as many questions as they could potentially answer. We have always considered the doctor-patient relationship and the confidentiality in that relationship to be among the most important and sacred of our duties. Getting appropriate and informed patient consent to have a confidential encounter recorded would be tricky at best, especially for a patient who was in pain or distress. The role of a body cam on medical malpractice claims is also extremely difficult to guess. I really would have no idea if these would be a boon to defendants, plaintiffs, or something of a wash."

Brian Flyer, MD: "Bad idea. The practice of medicine is already overly onerous, such an idea smacks of further distrust of doctors' abilities. The most obvious concerns would be violations of confidentiality, excessive exposure as fodder for lawyers, and unnecessary additional work reviewing such videos by doctors. The only potential benefit might be for doctors with early dementia, to help them remember what they did during the visit."

Michael Keeling, Esq.: "Videos during healthcare settings constitute a slippery slope. Americans have reasonable expectations of privacy in many situations. Such expectations may reasonably form within healthcare settings. Where such privacy expectations exist, practitioner body cameras are antithesis for the patient. To the extent body-camera videos are deemed part of patient records, HIPAA and related regulations are helpful in determining ownership, custodial responsibilities, etc. However, because many discovery exceptions exist, informed patients may have well-founded privacy concerns. Likely, such privacy concerns will be aired during any national discourse preceding widespread use of medical body-cameras."

Next Step in Telehealth?

Anand Swaminathan, MD: "Overall, I think we will be moving in this direction in the next decade as Google Glass and other wearable tech becomes more ubiquitous. The benefit would be of crystal clear documentation, but who would review this? Would it only be reviewed in cases where there are issues or problems? The amount of data would be phenomenally large too. Should all reassessments and interactions be recorded too? A lot of questions, and really this will be expensive. A true benefit would have to be proven before we invest. For now, many institutions record resuscitations and traumas as this can be very helpful for QA."

Seth Trueger, MD: " Perhaps this is too pie-in-the-sky, but maybe physicians would embrace body cameras if the recording would fulfill documentation requirements -- paired with accurate speech-to-text software and a quick medical decision-making addendum, maybe recording could free us from our EHRs?"

Zach Jarou, MD: "I appreciate this very practical approach to addressing the logistical challenges that would have to be overcome in order to implement a body camera system. However, as a resident in a busy emergency department, I do like the prospect of having most if not all of my charting automatically completed simply by strapping on a camera. And until we live in a world with better NLP [natural language processing] algorithms (we all know Siri isn't perfect), there's always the possibility of remotely feeding your camera stream to a virtual scribe in a less metropolitan (more affordable) location who can still help you with your notes (perhaps at a discounted price compared with their in-person counterparts)."

Legal Implications

Keeling: "Largely, the practitioner risks group into perceived error and omission liabilities. Most doctor-patient interactions result in the parties being satisfied -- but some result in conflict. Such conflicts are defined by sharply-contrasting perception contours by the involved persons. To the extent the practitioners' perceptions are factual, body-cam-based evidence (real-time videos) are the practitioner's friend. When parties disagree, each searches for evidence to support their respective points of view. Real-time video associated with key portions of such disputed matters often has the effect of yielding a quicker conclusion. But, as has been shown many times, such video evidence must be added to the totality of evidence -- not given special emphasis."

Trueger: "I'm curious how it will impact communication regarding sensitive topics, such as sexual, drug, and mental health history. While many physicians would likely be worried about always being watched, ultimately body cameras may in fact protect physicians with respect to liability. Certainly body cameras would more accurately capture what information was gathered than notes. "

Jarou: "In many malpractice cases the video presence of pertinent exam findings or historical information not captured in the written medical record could help physicians; however, the converse is also true, and with multiple health providers sometimes capturing different aspects of the history and physical, especially in academic teaching centers, I wonder which providers would be required to wear such cameras and how this information would be spliced together. What would become of findings included in the written medical record that could not be corroborated with video? And while a video may help to document the performance of certain steps of the physical examination, the interpretation of these maneuvers would still be left to the physician's verbalization of what was found. Were there really no crackles, wheezes, rhonchi, murmurs, rubs, or gallops?"

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